While radiologists have served in prominent positions in Washington, DC, in the past, none have ever served as White House fellow and special assistant to the president before the recent appointment of Pat Basu, MD, MBA, as one of 13 men and women to serve in the 2010–2011 class of fellows. An attending radiologist at Stanford University and the VA Palo Alto Health Care System in California, Basu is course director of health policy, finance, and economics and a former Rutherford fellow in the Washington ACR® office.
White House fellows usually spend a paid year working with senior White House staff, Cabinet secretaries, and other top-ranking officials, and their responsibilities include chairing interagency meetings, designing and implementing federal policy, and drafting speeches for Cabinet secretaries. Radiology Business Journal spoke with Basu to find out why he would leave the faculty of one of the most prestigious teaching institutions in the country (and take a 70% to 80% pay cut) to spend a year in the White House.
RBJ: Why now? What led you to Washington at this time?
Basu: I am a first-generation American. My parents had come to this country well over 40 years ago; my older brother (who happens to be a radiologist), my younger sister, and I were not born yet, but they came for the American dream. I still very much believe in the American dream and in the ideals and freedoms this country offers. I look back at all of the people who have believed in me: teachers, coaches, parents, family, and friends. With my energy, background, and training in medicine and business, I feel that there is something I owe and that I have to offer.
Many people told me the same thing: If you get this appointment, that would be incredible, but it is a bad time. We are in two wars, the economy is in a shambles, the health-care system is broken, the education system is broken; it’s tough, but that’s the nature of the work. If I can make a difference in the lives of people, that would be very fulfilling for me.
RBJ: As course director at Stanford of health policy, finance, and economics, you have a great vantage point from which to comment on how The Patient Protection and Affordable Care Act of 2010 could affect radiology. With so many references to accountability and bundling in the legislation, what are the dangers for radiology?
Basu: The biggest danger for radiology is not to be a part of the solution—not to be at the table. Radiologists are uniquely positioned to understand so many elements of the health-care system. We are in one of the few specialties that sees patients in the outpatient setting, the emergency department, and the inpatient setting. We are in one of the few specialties that sees patients for ailments from the brain to the lungs, the abdomen, and all the way down to the legs and toes. We also deal with a lot of high–capital-expenditure equipment that we have a great amount of control over; we are very uniquely positioned.
My biggest fear is that radiologists and physicians at large will not participate in the process. If you don’t participate in the process, you leave yourself open to not having a voice. I’ve seen that many times, in the past, in various physician capacities, and in people who are not members of the ACR. If you are not active directly, then you should be active indirectly. That is what they need to think about: the long-term future of health care.
RBJ: Are there specific opportunities for radiology to participate in meaningful reform?
Basu: Specifically, it would be in contributing to how we can maximize appropriate imaging. How can we decrease inappropriate imaging? More generally, a lot of people get fixated on the details of the conversation, and the devil is in the details. What it really takes is an initial conversation. Sit down with legislators and administrators and begin a conversation.
Here’s a story I share in a leadership class that I do: People on one side of the class are given a sheet of paper that says they need a bunch of oranges to make orange juice, and those on the other side are given a sheet of paper saying they need a bunch of oranges to use the peel to make lotion. They argue back and forth without realizing there is a win–win solution for both sides. If one side gets the peels and the other side gets the juice, they can both win.
All too often, all of the parties in medicine—radiologists, physicians in general, administrators, and legislators—are not